Diagnostic Studies Flashcards
Endoscopy (EGD)
Visualize muscosal lining of esophagus, stomach, duodenom
Information on degree of inflammation or other problems
BEFORE: Keep pt NPO 8 hrs. Signed consent. Sedation during procedure, may spray anesthesia on throat
AFTER: NPO until gag reflex returns. Temp checks q 15-30 for 1-2 hrs. Gargle w/ warm saline for sore throat relief
Colonoscopy
Directly visualizes colon up to ileocecal valve.
Used to diagnose/detect IBD, polyps, tumors, diverticulosis, dilate strictures.
BEFORE: Bowel prep is done.
EXPLAIN: Flexible scope will be inserted while pt side-lying. Sedation will be given.
AFTER: May experience abdominal cramps due to peristalsis b/c bowl is inflated w/ air. Observe for rectal bleeding, perforation. Check VS.
Video Capsule Endocsopy
Pt swallows capsule w/ camera.
Provides endoscopic visualization of GI tract.
Most commonly used to visualize small intestine and diagnose Crohn’s disease, small bowel tumors, bowel injury r/t NSAIDs, celiace disease, malabsorption. Identify possible GI bleeds.
Camera takes >50,000 images during 8 hr examination.
Not used in pts w/ suspected intestinal strictures.
BEFORE: pt fasts overnight. May have bowel prep like colonoscopy. Clear liquids resumed 2 hrs after pill swallowed. Food and meds 4 hrs after.
AFTER: return 8 hrs after swallow to have monitoring device removed
*Peristalsis causes passage of disposable capsule w/ bowel movements
Endoscopic Retrograde
Cholangiopancreatography (ERCP)
Fiberoptic endoscope w/ fluoroscopy is orally inserted into descending duodenum, then common bile and pancreatic ducts are cannulated. Contrast medium injected into ducts, allows direct visualization of structures.
Can be used to retrieve gallstone from common bile duct, dilate strictures, biopsy, diagnose pseudocysts.
BEFORE: explain. NPO 8 hr prior. Signed consent form. Administer sedation immediately before and during. Administer ordered antibiotics
AFTER: Check VS. Check signs of perforation or infection. Pancreatitis is common complication. Check returned gag reflex.
Sigmoidoscopy
Directly visualizes rectum and sigmoid w/ lighted flexible endoscope.
Used to detect tumors, polyps, inflammatory and infection diseases, fissures, hemorrhoids.
BEFORE: Administer enemas evening before and morning of. Clear liquids day before, no dietary restrictions may be necessary.
EXPLAIN: knee to chest position and take deep breaths during insertion of scope. Possible urge to defecate as scope is passed. Relax and let abdomen go limp.
Observe for rectal bleeding.
Liver Biopsy
Percutaneous procedure uses needle inserted between 6th/7th or 8th/9th intercostal spaces on right side to obtain specimen. Often done w/ ultrasound or CT guidance.
BEFORE: Check pts coagulation status. Ensure blood type is crossmatched. Take baseline VS. Signed consent.
EXPLAIN: holding of breath AFTER expiration when needle is INSERTED.
AFTER: Check VS q15min x 2, q30min x4, q1hr x4 to detect for internal bleeding. Keep pt lying on ride sight for minimum 2 hrs to splint site. Keep pt in bed flat for 12-14 hrs. Assess pt for complications such as bile peritonitits, shock, pneumothorax.
CT scan
Noninvasive radiologic examination, allows for exposures at different depths.
Detects biliary tract, liver, pancreatic disorders.
Use of oral/IV contrast medium accentuates density differences
EXPLAIN: procedure. Determine if sensitivity to iodine or shellfish if contrast material is used
Magnetic Resonance Imaging (MRI)
Noninvasive procedure using radiofrequency waves and a magnetic field.
Used to detect hepatobiliary disease, hepatic lesions, sources of GI bleeds and to stage colorectal cancer.
IV contrast medium may be used.
EXPLAIN: Procedure. Contraindicated in pts w/ metal implants or who are pregnant.
Abdominal Ultrasound
Detects abdominal masses, biliary/liver disease, gallstones.
Conductive gel is applied to skin and transducer is placed on area.
INSTRUCT: pt to be NPO 8-12 hrs prior. Air or gas can reduce quality of images. Food intake can cause gallbladder contraction resulting in suboptimal study.
Magnetic Resonance Cholangiopancreatography (MRCP)
Uses MRI technology to obtain images of biliary and pancreatic ducts.
EXPLAIN: procedure. Contraindicated in pts w/ metal implants ore those who are pregnant.
